Pre-test characteristics of unstable angina patients with obstructive coronary artery disease confirmed by coronary angiography
Objective As the mortality and rate of obstructive coronary artery disease (CAD) is low in patients with unstable angina (UA), better pre-test selection criteria for acute coronary angiography (CAG) is warranted. We aimed to validate the current guidelines against other clinical variables as predict...
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ftunivtroemsoe:oai:munin.uit.no:10037/14067 2023-05-15T17:39:23+02:00 Pre-test characteristics of unstable angina patients with obstructive coronary artery disease confirmed by coronary angiography Fladseth, Kristina Kristensen, Andreas Mannsverk, Jan T. Trovik, Thor Schirmer, Henrik 2017-10-31 https://hdl.handle.net/10037/14067 eng eng UiT Norges arktiske universitet UiT The Arctic University of Norway https://hdl.handle.net/10037/14067 openAccess Copyright 2017 The Author(s) VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750 MED-3910 Master thesis Mastergradsoppgave 2017 ftunivtroemsoe 2021-06-25T17:56:10Z Objective As the mortality and rate of obstructive coronary artery disease (CAD) is low in patients with unstable angina (UA), better pre-test selection criteria for acute coronary angiography (CAG) is warranted. We aimed to validate the current guidelines against other clinical variables as predictors of obstructive CAD in UA patients referred for acute CAG. Methods From 2005 to 2012, all CAGs performed at the University Hospital of North Norway, the sole provider of CAG in the region, were recorded in a registry. We included 979 admissions of UA in the primary catchment area to enable retrospective collection from patient hospital records. Obstructive CAD was defined as ≥50% stenosis and considered prognostically significant if found in the left main stem, proximal LAD or in all three main coronary arteries. Characteristics were analysed by logistic regression analysis. A score was developed using odds ratios from significant factors in a multivariable model. Results The overall rate of obstructive CAD was 45%, and the rate of prognostically significant CAD was 11%. The ACC/AHA and ESC guidelines had an area under the curve (AUC) of 0.58. Adding clinical information increased the AUC to 0.77 (95% CI 0.74-0.80). Applying the derived score, we found that 56% (n=546) of patients with a score of <13 had a negative predictive value of 95% for prognostic obstructive CAD. Conclusions CAG can be postponed or cancelled in up to 56% of UA patients, by improving pre-test selection criteria with the addition of clinical parameters to current guidelines. Master Thesis North Norway University of Tromsø: Munin Open Research Archive Norway |
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University of Tromsø: Munin Open Research Archive |
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English |
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VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750 MED-3910 |
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VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750 MED-3910 Fladseth, Kristina Kristensen, Andreas Mannsverk, Jan T. Trovik, Thor Schirmer, Henrik Pre-test characteristics of unstable angina patients with obstructive coronary artery disease confirmed by coronary angiography |
topic_facet |
VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750 MED-3910 |
description |
Objective As the mortality and rate of obstructive coronary artery disease (CAD) is low in patients with unstable angina (UA), better pre-test selection criteria for acute coronary angiography (CAG) is warranted. We aimed to validate the current guidelines against other clinical variables as predictors of obstructive CAD in UA patients referred for acute CAG. Methods From 2005 to 2012, all CAGs performed at the University Hospital of North Norway, the sole provider of CAG in the region, were recorded in a registry. We included 979 admissions of UA in the primary catchment area to enable retrospective collection from patient hospital records. Obstructive CAD was defined as ≥50% stenosis and considered prognostically significant if found in the left main stem, proximal LAD or in all three main coronary arteries. Characteristics were analysed by logistic regression analysis. A score was developed using odds ratios from significant factors in a multivariable model. Results The overall rate of obstructive CAD was 45%, and the rate of prognostically significant CAD was 11%. The ACC/AHA and ESC guidelines had an area under the curve (AUC) of 0.58. Adding clinical information increased the AUC to 0.77 (95% CI 0.74-0.80). Applying the derived score, we found that 56% (n=546) of patients with a score of <13 had a negative predictive value of 95% for prognostic obstructive CAD. Conclusions CAG can be postponed or cancelled in up to 56% of UA patients, by improving pre-test selection criteria with the addition of clinical parameters to current guidelines. |
format |
Master Thesis |
author |
Fladseth, Kristina Kristensen, Andreas Mannsverk, Jan T. Trovik, Thor Schirmer, Henrik |
author_facet |
Fladseth, Kristina Kristensen, Andreas Mannsverk, Jan T. Trovik, Thor Schirmer, Henrik |
author_sort |
Fladseth, Kristina |
title |
Pre-test characteristics of unstable angina patients with obstructive coronary artery disease confirmed by coronary angiography |
title_short |
Pre-test characteristics of unstable angina patients with obstructive coronary artery disease confirmed by coronary angiography |
title_full |
Pre-test characteristics of unstable angina patients with obstructive coronary artery disease confirmed by coronary angiography |
title_fullStr |
Pre-test characteristics of unstable angina patients with obstructive coronary artery disease confirmed by coronary angiography |
title_full_unstemmed |
Pre-test characteristics of unstable angina patients with obstructive coronary artery disease confirmed by coronary angiography |
title_sort |
pre-test characteristics of unstable angina patients with obstructive coronary artery disease confirmed by coronary angiography |
publisher |
UiT Norges arktiske universitet |
publishDate |
2017 |
url |
https://hdl.handle.net/10037/14067 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
North Norway |
genre_facet |
North Norway |
op_relation |
https://hdl.handle.net/10037/14067 |
op_rights |
openAccess Copyright 2017 The Author(s) |
_version_ |
1766140148346519552 |